Age-Standardized Monthly Mortality by Year (per 10,000 inhabitants), Puerto Rico, 2010-2011 to 2017-2018. U.S. Census and Displacement Scenarios for 2017-2018. Graphic: GW Milken Institute SPH15 September 2018 (Desdemona Despair) – On Thursday, Trump took time from his busy schedule to tweet that the official death toll in Puerto Rico from Hurricane Maria “was done by the Democrats in order to make me look as bad as possible”.It’s hard to decide where to start with such a cockamamie claim, so I’ll stick with the facts: for anybody who watched closely the destruction of modern Puerto Rico and other Caribbean islands by Hurricanes Irma and Maria, it was obvious that the official count of 64 dead was too low by a couple of orders of magnitude.Two independent academic studies were undertaken to estimate the excess mortality due to Hurricane Maria:

  • Harvard University surveyed 3,299 randomly chosen households across Puerto Rico and estimated an excess mortality of about 4,645 people (95 percent CI, 793 to 8,498) from 20 September 2017 through 31 December 2017. The results were published in the New England Journal of Medicine.
  • George Washington University conducted an epidemiological study [pdf] and estimated there were 2,975 excess deaths (95 percent CI, 2,658 to 3,290) in Puerto Rico due to Hurricane Maria from September 2017 through the end of February 2018.

In August 2018, the government of Puerto Rico accepted the lower estimate and raised the official death toll from Hurricane Maria from 64 to 2,975.Also obvious to attentive observers was the fact that the U.S. government’s response was woefully inadequate. In July 2018, FEMA issued a report admitting that it had drastically underestimated the devastation that Hurricane Maria was about to unleash on Puerto Rico in 2017, but Trump has never acknowledged the failure. It fell to Rep. Nydia Velazquez, a New York Democrat, to state plainly how the U.S. government failed the people of Puerto Rico:

“These numbers are only the latest to underscore that the federal response to the hurricanes was disastrously inadequate and, as a result, thousands of our fellow American citizens lost their lives.”

With its critical infrastructure wiped out, Puerto Rico essentially must be rebuilt from scratch. In the immediate aftermath of Hurricane Maria, it was clear that this will be an immensely expensive undertaking, on the scale of tens of billions of dollars. The final report on reconstructing Puerto Rico, Transformation and Innovation in the Wake of Devastation: An Economic and Disaster Recovery Plan for Puerto Rico, calls for $139 billion.It’s hard to imagine a world in which the Republican President and Congress would authorize this kind of spending – when they were willing to allow thousands of U.S. citizens to die of neglect.